Tissue excision and cutting apparatus and its forceps

ABSTRACT

A tissue excision and cutting apparatus used by inserted into a trocar for cutting off a part of tissue as a sample piece for such a diagnosis in a laparoscopic surgery or the like. The apparatus comprises a resection blade having an inner hollow cylinder with a cutting blade at its tip end, and a forceps having at its tip end a clamp having a movable jaw capable of opening and closing which is joined to a fixed jaw with a chopping block piece, open-close mechanism having an operation part for opening and closing the movable jaw, and a longitudinal penetrating passage into which the resection blade is inserted and moves back and forth therein.

FIELD OF THE INVENTION

[0001] The present invention relates to a newly developed tissueexcision and cutting apparatus and resection forceps for cutting off apart of human tissue as a sample piece for such a diagnosis inlaparoscopic surgery or the like.

PRIOR ART

[0002] A tissue excision and cutting apparatus for surgical operationhas been -used together with a forceps and a laparoscope and variouskinds of such related apparatuses have been proposed till up now.

[0003] One example has a cylindrical resection blade rotated by a motorin a guide cylinder to be inserted into a trocar, and forceps forgrasping an objective tissue inserted into the resection blade.

[0004]FIGS. 20a to 20 c show how to use the tissue excision and cuttingapparatus of prior art and the forceps to be combined therewith.

[0005] A tissue excision and cutting apparatus 101, as shown in FIG.20a, comprises a main body 103 with grip portion, a guide cylinder 102 ato be inserted into a trocar (not shown), and a resection blade 102 bwith a blade at its tip end which is driven to be rotated in the guidecylinder 102 a by a motor (not shown).

[0006] On the other hand, a forceps 104 to be combined with the tissueexcision and cutting apparatus 101 in such a manner as shown in FIG.20(a) has a main axis 104 a with at its tip end a clamp 104 b which canbe opened and closed by manual operation of one hand.

[0007] According to such a tissue excision and cutting apparatus 101,while observing around the tip end of the tissue excision and cuttingapparatus 101 inserted into the trocar by a laparoscope (not shown), atissue A may be grasped by the clamp 104 b of the forceps 104 byapproaching the forceps to the tissue A, after then the forceps 104 iswithdrawn into the guide cylinder 102 a in the state of grasping tissueA to bring it into contact with the blade of rotating resection blade102 b, by which a part of tissue A can be cut off as a sample piece (SeeFIGS. 20a to 20 c).

[0008]FIG. 21 shows a tissue excision and cutting apparatus according tothe prior art in which a forceps and a resection blade are integratedwherein FIG. 21a illustrates a front view of its partial verticalsection and FIG. 21b its rear view.

[0009] A tissue excision and cutting apparatus 111, as shown in thesefigures, comprises a tissue cutting resection blade 112 composed of acylindrical blade 112 b and a guide cylinder 112 a, a main body 113 witha grip 113 a and holing portion 113 b for the forceps 114, a forceps 114itself, a forceps withdrawing mechanism 115 with a trigger 115 a forfinger operation, a forceps open-close mechanism 116 with a fingeroperation part 116 a, and a motor 118 for rotating the blade 112 b.

[0010] In this figure, turning operational direction of the open-closefinger operation part 116 a is shown as an arrow corresponding to openand close operations of the clamp 114 b wherein opening direction isshown as an actual line and closing direction is shown as a dotted line,whereas sequential pulling operation of the trigger 115 a is also shownby an arrow corresponding to with drawing operation of the forceps.

[0011] According to such a tissue excision and cutting apparatus 111,operating a laparoscope (not shown) by a left hand while observingobjective tissue with the apparatus 111 held by a right hand, andadvancing the forceps 114 to the objective tissue, where the open-closeoperation part 116 a is turned in a closing direction by a thumb C ofthe right B hand as shown in a dotted line in FIG. 21(b), thus enablingto grasp the objective tissue by the clamp 114 b of the forceps 114.

[0012] After grasping the tissue A, the motor 118 is driven to rotateresection blade 112 b and the trigger 115 a is repeatedly operated by aforefinger D of the right hand B, thereby cutting off tissue A by theresection blade 112 b in cylindrical shape. And the apparatus is soconstructed that tissue thus grasped is prevented from dropping out evenif the thumb C is departed from the open-close operation part 116 a.

[0013] According to the tissue excision and cutting apparatus 111described above, comparing to the one shown in FIG. 20, the forceps canbe operated by a thumb C and retraction can be executed by a forefingerD, with its main body held only by one hand, thus enabling another handto operate a laparoscope or the like.

[0014] In any of above-mentioned tissue excision and cutting apparatusof the prior art, tissue is drawn into a guide cylinder and cut offtherein while rotating a resection blade. Therefore, in such a method,tissue would not be sharply or finely cut off.

[0015] In other words, in such a method tissue is apt to be torn off andpartly broken when tissue is drawn into the guide cylinder to be cut offso that it makes difficult to surely and sharply cut off the tissue, orthe part of tissue could not be cut off well.

[0016] In addition, in such a prior tissue excision and cuttingapparatus, the resection blade is exposed from a guide cylinder whentissue is cut off. Therefore, there would be a fear that organ not to becut off or an end-bag (explained hereinafter referring to FIG. 6 to FIG.9) used for laparoscopic surgery happens to be damaged.

SUMMARY OF THE INVENTION

[0017] The present invention has proposed to solve the abovementionedproblems.

[0018] Accordingly, it is the primary object of the invention to providea tissue excision and cutting apparatus which can finely and sharply cutoff an objective tissue and a resection forceps to be used for theapparatus.

[0019] It is another object to provide a tissue excision and cuttingapparatus which doesn't have such a fear and a forceps used for theapparatus.

[0020] In the present invention, a tissue excision and cutting apparatusused by inserted into a trocar for cutting off a part of tissue forsampling in laparoscopic surgery or the like comprises a resection bladewith an inner hollow cylinder body having a cutting blade at its tipend, and a forceps for cutting off a part of tissue to be cut off as asample piece.

[0021] The forceps has at its tip end a clamp for grasping a part oftissue which has a movable jaw capable of opening and closing and isjoined to a fixed jaw vertically provided with a chopping block piece,an open-close mechanism with a hand operation part for opening andclosing by manual operation, and a longitudinal penetrating passage intowhich the resection blade is inserted and moves back and forth therein.

[0022] The tissue excision and cutting apparatus is constructed suchthat resection blade and the forceps are combined with when using it.

[0023] The apparatus is characterized in that the penetrating passage ofthe forceps is constructed such that the resection blade is insertedinto and moves back and forth therein and one of the clamp of theforceps is a fixed jaw provided at its chip end with a chopping blockpiece servicing as a stopper plate for the blade of resection blade. Thechopping block piece functions as the so called chopping block for theblade of the resection blade, thereby enabling to cut off an objectivetissue by pressing it in such manner as not in the prior pull-in-typetissue excision and cutting apparatus, thus any of tissues can be finelyand surely cut off.

[0024] In addition, in the apparatus, other organ or an endo-bag isn'tdamaged because the resection blade is contained and hidden in the clampof the forceps, thereby achieving safety.

[0025] If the shape of a part where the resection blade is contacted iscontrived, tissue can be cut off not only by pressing on the resectionblade a chopping block piece but also by shearing the resection bladeand the chopping block piece. For example, when the chopping block pieceis normally formed as such cylindrical shape that it has an innerdiameter in which the outer diameter of cylindrical blade of theresection blade is just engaged, tissue can be sheared to be cut off bycylindrical shape, or the chopping block piece and the resection blade.

[0026] In other embodiment of the present invention, a tissue excisionand cutting apparatus used by inserted into a trocar for cutting off apart of tissue for sampling in laparoscopic surgery or the likecomprises a resection blade with an inner hollow cylinder body having acutting blade at its tip end, and a forceps for cutting off a part oftissue as a sample piece wherein the resection blade is capable ofrotating by driving a rotary driving mechanism and the forceps has atits tip end a clamp for grasping a part of tissue to be cut off whichhas a movable jaw capable of opening and closing and is joined to afixed jaw vertically provided with a chopping block piece, an open-closemechanism with a hand operation part for opening and closing by manualoperation, and a longitudinal penetrating passage into which theresection blade is inserted and moves back and forth therein.

[0027] According to such a tissue excision and cutting apparatus, theresection blade is capable of rotating by a rotary driving mechanismcomprised of a motor by operating a switching means such a foot pedal orthe like. Therefore, tissue can be cut off and sampled more smoothly.

[0028] Further in another tissue excision and cutting apparatus of thepresent invention, the hand operation part of the forceps is constructedsuch that it can be held by one hand and the movable jaw can be operatedby the one hand. Therefore, the apparatus is very convenient forhandling because forceps can be held and manually operated by one handwhile the resection blade can be operated by another hand.

[0029] Further in other embodiment of the present invention, a choppingblock piece of the resection blade is formed with a blade receivingsurface on which the whole circumference of the blade contacts.

[0030] According to such construction, cut end of tissue by theresection blade can be done sharply and finely by pressing the blade ofthe resection blade onto the surface.

[0031] In still another embodiment of the invention, a sealing mechanismfor airtightly sealing the penetrating passage is further provided forisolating ventilation of the open air even when the forceps is insertedinto the passage or is pulled out from the passage.

[0032] According to such construction, outer air is prevented fromentering in abdominal cavity or the endo-bag through the penetratingpassage or especially pneumoperitoneum gas is prevented from leaking outwhen being filled in the endo-bag.

[0033] In other embodiment of the invention, the sealing valve mechanismis detachable and exchangeable for the penetrating passage.

[0034] Therefore, used it is very useful for preventing contamination orcontagion since it can be easily exchanged every time the forceps isused.

[0035] In still other embodiment of the invention, the resection bladefurther comprises a sealing rod for airtightly sealing the inner of thehollow cylinder body and a push shaft for outward extruding a part oftissue cut off and held in the hollow cylinder body as a sample piecewhich is airtightly inserted into the cylinder body from a push holeprovided at the rear end of the sealing rod.

[0036] According to such tissue excision and cutting apparatus, theinner of the hollow cylinder body of the resection blade can be keptairtight by the sealing rod and the push rod so that the tissue cut offas a sample piece is prevented from dropping out from the hollowcylinder body even when the tip of the resection blade is directeddownward for extracting the resection blade from the forceps. And thecut off tissue held in the hollow cylinder body can be easily extrudedby releasing the sealing and pushing the push shaft into the inner ofthe hollow cylinder after when the resection blade is moved to apredetermined place.

[0037] In other embodiment of the invention, the resection blade furthercomprises a sealing push rod airtightly inserted into the hollowcylinder body from an insertion opening provided at the rear end of thecylinder body, and a simple suction means which is connected to thesealing push rod for keeping the inner portion of the hollow cylinderbody airtight to hold a part of tissue cut off by the resection blade.

[0038] According to such tissue excision and cutting apparatus, the cutoff tissue as a sample piece held in the hollow cylinder body can besurely prevented from dropping out by effecting sucking force by meansof the simple suction means. Further, the cut off tissue held in thehollow cylinder body can be easily extruded outward by releasing thesucking force and pushing a sealing push rod into the hollow cylinderbody after moving to a predetermined place.

[0039] In still further other embodiment of the tissue excision andcutting apparatus, the resection blade further comprises a sealingsuction rod into which a sealing suction mechanism is incorporated and apush rod for outward extruding the tissue cut of f and held in thehollow cylinder body as a sample piece wherein the sealing suction rodairtightly seals the inner portion of the hollow cylinder and holds thetissue by keeping airtight, and the push rod is airtightly inserted inthe hollow cylinder body from a push hole provided at the rear end ofthe sealing suction rod.

[0040] According to such tissue excision and cutting apparatus, the cutoff tissue as a sample piece held in the hollow cylinder body can besurely prevented from dropping out by effecting sucking force by meansof the simple suction means. Further, the cut of f tissue held in thehollow cylinder body can be easily extruded outward by releasing thesucking force and pushing a sealing push rod into the hollow cylinderbody after moving to a predetermined place. In addition, it is moreconvenient to handle it because sealing suction rod and a sealingsuction mechanism are incorporated into the resection blade together.

[0041] In other embodiment of the tissue excision and cutting apparatus,the resection blade further comprises a suction sampling collectingmeans which is detachably connected to the rear end of the hollowcylinder body for sucking and collecting a part of tissue cut off as asample piece by the resection blade.

[0042] According to such a tissue excision and cutting apparatus, sincethe suction sampling collecting means sucks to collect by effectingactive suction force instead of keeping airtight in the hollow cylinderbody, the cut off tissue can be easily and sequentially suck andcollected in the sampling collecting means.

[0043] In other embodiment of the tissue excision and cutting apparatus,a holding craw similar to thorn is provided in inner surface adjacent tothe tip end of resection blade for preventing dropping out the tissuecut off as a sample piece by peripherally and partially holding it.

[0044] In the present invention, a forceps used together with thepresent apparatus has been also proposed, wherein the forceps comprisesa clamp provided at a tip end of the forceps and having a movable jawcapable of opening and closing which is joined to a fixed jaw providedwith a chopping block piece, an open-close mechanism with a handoperation part for opening and closing the movable jaw, and alongitudinal penetrating passage into which the resection blade isinserted and moves back and forth therein.

[0045] Such a forceps is the one used for the tissue excision andcutting apparatus of the present invention, and accordingly a part oftissue can be finely and surely cut off.

[0046] When such a forceps is used, any kinds of resection blade whichare rotatable or not rotatable can be also employed and a chopping blockpiece may serve as the so called a cutting board.

[0047] According to other embodiment of the forceps, the operation partof the forceps is constructed such that it can be held by one hand andthe movable jaw can be operated for opening and closing by manualoperation of the one hand.

[0048] Further in another tissue excision and cutting apparatus of thepresent invention, the operation part of the forceps is constructed suchthat it can be held by one hand and the movable jaw can be operated bythe one hand. Therefore, the apparatus is very convenient for handlingbecause forceps can be held and manually operated by the same one handwhile the resection blade can be operated by another hand.

[0049] Therefore, it is easy and convenient to handle such a forcepsbecause it can be opened and closed and held the same one hand withanother hand operating a resection blade.

[0050] Further in other embodiment of the present invention, a choppingblock piece of the resection blade is formed with a blade receivingsurface on which the whole circumference of the blade contacts.

[0051] According to such construction, a part of tissue grasping by theclamp can be sharply and finely cut off by pressing the blade of theresection blade onto the surface, by which a sample piece of tissue witha sharp cut end can be obtained.

[0052] Still another embodiment of the invention, a sealing mechanismfor airtightly sealing the penetrating passage is further provided forisolating ventilation of the open air even when the forceps is insertedinto the passage or is pulled out from the passage.

[0053] According to such construction, outer air is prevented fromentering in abdominal cavity or the endo-bag through the penetratingpassage and especially pneumoperitoneum gas is well prevented fromleaking out when being filled in the endo-bag.

[0054] In other embodiment of the invention, the sealing valve mechanismis detachable and exchangeable for the penetrating passage.

[0055] Therefore, according to such construction, it is very useful forpreventing contamination or contagion since it can be easily exchangedevery time the forceps is used.

BRIEF DESCRIPTION OF DRAWINGS

[0056] These and other objects and advantages of the present inventionwill become clear from the following description with reference to theaccompanying drawings, wherein:

[0057]FIG. 1 is a partially cutaway front view showing one embodiment ofa tissue excision and cutting apparatus of the present invention.

[0058]FIG. 2 is a perspective view of a clamp of a tissue excision andcutting apparatus of the present invention.

[0059]FIG. 3(a) is a partial cutaway front view when the clamp is openedaccording to a tissue excision and cutting apparatus of the presentinvention.

[0060]FIG. 3(b) is a partial cutaway front view when it is closedaccording to a tissue excision and cutting apparatus of the presentinvention.

[0061]FIG. 4(a) is a vertical section when tissue is cut and

[0062]FIG. 4(b) is a vertical section after tissue is cut.

[0063]FIG. 5(a) shows a vertical section when tissue is cut according toa tissue excision and cutting apparatus of the present invention.

[0064]FIG. 5(b) shows a vertical section after tissue is cut accordingto a tissue excision and cutting apparatus of the present invention.

[0065]FIG. 6 is an explanatory view showing sampling procedure 1 fortissue sample by means of the tissue excision and cutting apparatus ofthe present invention.

[0066]FIG. 7 is an explanatory view showing sampling procedure 2 fortissue sample by means of the tissue excision and cutting apparatus ofthe present invention.

[0067]FIG. 8 is an explanatory view showing sampling procedure 3 fortissue sample by means of the tissue excision and cutting apparatus ofthe present invention.

[0068]FIG. 9 is an explanatory view showing sampling procedure 4 fortissue sample by means of the tissue excision and cutting apparatus ofthe present invention.

[0069]FIG. 10 is an explanatory view showing sampling procedure 5 fortissue sample by means of the tissue excision and cutting apparatus ofthe present invention.

[0070]FIG. 11 is a partial cutaway front view showing one embodiment ofa tissue excision and cutting apparatus of the present inventioncombined with a rotatable resection blade.

[0071]FIG. 12(a) is a front view of a partial vertical section accordingto a tissue excision and cutting apparatus of another embodiment of thepresent invention.

[0072]FIG. 12(b) is a fragmental view in the direction of the arrow Xaccording to a tissue excision and cutting apparatus of anotherembodiment of the present invention.

[0073]FIG. 13(a) shows when the sealing mechanism is loaded according toa tissue excision and cutting apparatus of the present invention.

[0074]FIG. 13(b) shows after it is loaded, and

[0075]FIG. 13(c) shows when the resection blade or the rotatableresection blade is inserted according to a tissue excision and cuttingapparatus of the present invention.

[0076]FIG. 14(a) is its front view according to a tissue excision andcutting apparatus of the present invention.

[0077]FIG. 14(b) is a partial vertical section according to a tissueexcision and cutting apparatus of the present invention.

[0078]FIG. 15 is an external front view of one embodiment of a rotatableresection blade provided with holding craw as shown in FIG. 14.

[0079]FIG. 16(a) is its front view according to a tissue excision andcutting apparatus of the present invention.

[0080]FIG. 16(b) is its partial vertical section according to a tissueexcision and cutting apparatus of the present invention.

[0081]FIG. 17 is a partial vertical section explaining operation of oneembodiment of a sealing rod used for a resection blade or a rotatableresection blade of the present invention.

[0082]FIG. 18(a) is a partial vertical section before tissue is cutaccording to a tissue excision and cutting apparatus of the presentinvention.

[0083]FIG. 18(b) is a partial vertical section after tissue is cutaccording to a tissue excision and cutting apparatus of the presentinvention.

[0084]FIG. 18(c) is a partial vertical section when a tissue sample issuck and held according to a tissue excision and cutting apparatus ofthe present invention.

[0085]FIG. 19(a) to FIG. 19(f) explain operation of a suction andsampling means used for a resection blade or a rotatable resection bladeof the present invention.

[0086] FIGS. 20(a), (b), (c) show one usage of a tissue excision andcutting apparatus and a forceps of the prior art.

[0087]FIG. 21(a) is a front view of a partial vertical section a tissueexcision and cutting apparatus integrated with a forceps according tothe prior art.

[0088]FIG. 21(b) is its rear view of a tissue excision and cuttingapparatus integrated with a forceps according to the prior art.

DETAILED DESCRIPTION OF THE INVENTION

[0089] Now embodiments of tissue excision and cutting apparatus will beexplained referring to the drawings.

[0090]FIG. 1 is a partially cutaway front view of one embodiment of atissue excision and cutting apparatus of the present invention.

[0091] A tissue excision and cutting apparatus comprises a resectionblade 7 having an inner hollow cylinder body formed with a cutting blade7 a at its tip end, and a forceps 6 for cutting off a part of tissue Aas a sample piece.

[0092] The forceps 6 has a clamp 3 for grasping a part of tissue A inwhich the clamp has a movable jaw 3 b capable of opening and closingjoined to a fixed jaw 3 a with a chopping block piece 2, an open-closemechanism 5 with an operation part 5 a for opening and closing themovable jaw 3 b, and a longitudinal penetrating passage 4 into which theresection blade 7 is inserted and moves back and forth therein.

[0093] The chopping block piece 2 is a characteristic of the tissueexcision and cutting apparatus 1, is vertically provided at the fixedjaw 3 a in such manner it intercepts the penetration passage 4 as astopper of the resection blade 7 to be inserted into the longitudinalpenetrating passage 4 for cutting tissue A, and works as so called acutting board.

[0094] The fixed jaw 3 a is provided normally at one end of a forcepscylinder 4 a with the longitudinal penetrating passage 4 therein, andthe movable jaw 3 b is joined to the fixed jaw 3 a by a hinge 3 c so asto be pivotally opened and closed. The fixed jaw 3 a, the movable jaw 3b and the hinge 3 c construct the clamp 3. These parts will be detailedhereinafter.

[0095] The longitudinal penetrating passage 4 is constructed with acylindrical body as the forceps cylinder 4 a and the open-closemechanism 5, which will be also explained hereinafter, is provided inthe forceps cylinder 4 a and on the opposite side of the fixed jaw 3 ain such a manner as to form the longitudinal penetrating passage 4. Theoperation part 5 a for holding the tissue excision and cutting apparatus1 by one hand and for opening and closing the movable jaw 3 b isprovided at a back end of the open and close mechanism 5 in such amanner that it directs approximately normally to the longitudinaldirection of the forceps cylinder 4 a.

[0096] The resection blade 7 is comprised of a cylinder body 7 b formedwith the cylindrical blade 7 a at its one end and a holding portion 7 cfor holding the resection blade 7 at its periphery of the other end, andis so constructed as to contain cut off tissue as a sample piece Ac atits tip of the hollow cylinder.

[0097] At the back end of the resection blade is provided a sealing rod8 for airtightly sealing the inner portion of hollow cylinder body and apush rod 9 for extruding the cut of f tissue as a sample piece Ac bybeing airtightly inserted into the hollow cylinder body from a push hole(not shown) provided at the back end of the sealing rod 8.

[0098] The sealing rod 8 and the push rod 9 are detachable on theresection blade 7 if necessary and they will be explained hereinafter.

[0099] According to the tissue excision and cutting apparatus 1, tissueA can be grasped with a clamp 3 only by closing operation of theoperation part 5 a (solid line arrow in the figure) while holding thesame part 5 a by one hand. Under such a condition, inserting theresection blade 7 into the longitudinal penetrating passage 4 of theforceps 6 by another hand and bringing the blade 7 a of the resectionblade 7 into direct contact with the tissue A by pressing it or bringingthe blade 7 a of the resection blade into contact with the tissue Awhile twisting it right and left at its discretion, thereby cutting offthe objective tissue A to obtain only a part of the objective tissue Aas a sample piece Ac without damaging the surrounding tissues and withsafety and sureness.

[0100] Namely, according to the tissue excision and cutting apparatus,since the chopping block piece 2 body provided at the tip of the fixedjaw 3 a serves as a chopping board, only a part of the objective tissueA held by the clamp 3 can be safely and surely cut off comparing to theapparatus such a prior type that the tissue is cut off while being drawninto a cylinder of the resection blade 7.

[0101] Further, the clamp 3 can be opened and closed by manual operationof one hand while holding the tissue excision and cutting apparatus 1 bythe one hand and thereby enabling to operate the resection blade 7 bythe other hand. Therefore, the required operation for cutting off tissuecan be done by one person so that such an apparatus is suitable forlaparoscopic surgery or the like.

[0102]FIG. 2 is a perspective view of the clamp 3 of the tissue excisionand cutting apparatus 1. The repetition explanation will be omitted byadding same reference numerals to the parts already explainedhereinafter.

[0103] The clamp 3 is constructed such that the fixed jaw 3 a isattached with the movable jaw 3 b so as to be opened and closed and themovable jaw 3 b is connected to the open-close mechanism 5 operated bythe operation part 5 a. The mechanism 5 is provided so as not tointerrupt the blade 7 a of the resection blade 7 forwarding to thechopping block piece 2, or the mechanism is provided in such manner asto assure the longitudinal penetrating passage 4.

[0104] The fixed jaw 3 a is provided with an arch-like support body 3 caconstructing a hinge 3 c for supporting the movable jaw 3 b so as to beopened and closed. An escape hole of this arch form constructs thelongitudinal penetrating passage 4. A hinge hole (not shown) is providedat the upper projection of the support body 3 ca, a hinge pin 3 cb isinserted into the hole, and a hinge hole (not shown) provided at theopen-close end of the movable jaw 3 b is outwardly engaged into thehinge pin 3 cb.

[0105] The support body 3 ca and the hinge pin 3 cb construct the hinge3 c and the movable jaw 3 b can be rotate around the hinge pin 3 cb as arotation rod so as to be opened and closed for the fixed jaw 3 a.

[0106] The attachment method of the movable jaw 3 b on the fixed jaw 3 aso as to be opened and close isn't limited to the above-mentioned onewhich uses a hinge supporting with one rod. Other method wherein themovable jaw 3 b is connected to the fixed jaw 3 a with plural arms so asto form a parallelogram and the movable jaw 3 b is opened or closedalways keeping parallel to the fixed jaw 3 a may be used.

[0107] A link arm 3 ba is extended from the open-close end of themovable jaw 3 b so as to make a prescribed angle with the movable jaw 3b, and a link hole (not shown) is provided at its tip and rotatablyconnected to a link member 5 b by a link pin 5 ba. The link member 5 bis further rotatably connected to a connecting rod 5 c connecting theoperation part 5 a side and the clamp 3 side of the forceps cylinder 4 aand is provided with the escape hole constructing the longitudinalpenetrating passage 4.

[0108] A hook 3 bb for preventing moving of the tissue to be held bybiting into the tissue is provided at the tip opposite to the link arm 3ba side of the movable jaw 3 b facing to the fixed jaw 3 a, however sucha 3 bb hook isn't inevitable.

[0109] According to such a clamp 3 constructed mentioned above, themovable jaw 3 b is closed (a solid line arrow) when the connecting rod 5c is moved rear (into a solid line arrow), the movable jaw 3 b is opened(a broken line arrow) when the connecting rod 5 c is moved near (into abroken line arrow).

[0110] Any of them are provided so as to assure the longitudinalpenetrating passage 4 for forwarding the resection blade 7 to beattached with the chopping block piece 2 provided at the tip of thefixed jaw 3 a without being an obstacle. Further, the longitudinalpenetrating passage 4 may assure insertion of the resection blade 7 andmay be provided with an open end as mentioned above other than theforceps cylinder 4 a which is closed perpendicular to the longitudinaldirection.

[0111] A connection 3 aa is vertically connected with the fixed jaw 3 a,connects the forceps cylinder 4 a and the fixed jaw 3 a, and is providedwith a support hole for inserting the connecting rod 5 c slidably.

[0112]FIG. 3 shows performance of the operation part 5 a and theopen-close mechanism 5 of the tissue excision and cutting apparatus 1 ofthe present invention. FIG. 3(a) is a partial cutaway front view whenthe clamp 3 is opened and FIG. 3(b) is a partial cutaway front view whenit is closed.

[0113] The connecting rod 5 c passes through the connection 3 aa and theupper part of the forceps cylinder 4 a assuring the longitudinalpenetrating passage 4, extends to the operation part 5 a side of theforceps cylinder 4 a, and is connected to a slide block 5 e.

[0114] The slide block 5 e is contained in an operating mechanism case 5d slidably fixed at the operation part 5 a side of the forceps cylinder4 a and the back and forth movement of the slide block 5 e istransmitted to the clamp 3 side of the forceps cylinder 4 a via theconnecting rod 5 c so that the link member 5 b is moved back and forth.The slide block 5 e is provided with a pair of link pins 5 f at bothends of peripheral and a pair of link plates 5 e connecting theoperation part 5 a and the slide block 5 e are outwardly inserted intothe link pins 5 g so as to be slidable. A slide long hole 5 da workingas a guide of moving of the link pins 5 g accompanying with back andforth movement of the slide block 5 e is provided at a positioncorresponding to the link pins 5 g of the operation mechanism case 5 dso as to allow back and forth sliding of the slide block 5 e and preventrotation of the slide block 5 e.

[0115] A pair of link support pins 5 db are provided forward theoperation mechanism case 5 d and a rear cover 5 h is provided at backend of the case 5 d.

[0116] The operation part 5 a is comprised of a fixed operation part 5aa fixedly provided for the operation mechanism case 5 d and a movableoperation part 5 ab which can be opened or closed by rotating the linksupport pins 5 db of the case 5 d as a rotating rod against the fixedoperation part 5 aa. Such rotation is accomplished by that a linksupport hole 5 ac provided for the movable operation part 5 ab isoutwardly inserted in the pins 5 db of the case 5 d. A link support 5 adassociating to a link plate 5 f outwardly inserted in the link pins 5 gof the slide block 5 e and a finger stopper 5 ae for acting operatingforce of fingers in both open and close directions are provided for themovable operation part 5 ab.

[0117] A link mechanism is constructed by the link pins 5 g of the slideblock 5 e sliding back and forth in the operation mechanism case 5 d,the link plate 5 f, the link support 5 ad and the link support hole 5 acof the removable operation part 5 ab, and the link support pin 5 db ofthe case 5 d. When the movable operation part 5 ab of the operation part5 a is opened or closed by such a link mechanism, the movable jaw 3 b ofthe clamp 3 can be opened or closed.

[0118] When the fixed operation part 5 aa of the operation part 5 a isheld by one hand as shown in FIG. 3(a) and a first finger and a longfinger (they are called “operation fingers”) are operated into closingdirection (a solid line arrow in the figure) so as to clip the fingerstopper 5 ae, the slide block 5 e goes back, such a movement istransferred to the link member 5 b by means of the connecting rod 5 c,the link arm 3 ba of the clamp 3 is rotated, and the movable jaw 3 b ismoved into closing direction (a solid line arrow in the figure).

[0119] On the other hand, when the operation fingers are operated intoopen direction (a broken line arrow in the figure) as shown in FIG.3(b), the movement is transmitted to the link member 5 b by theconnecting rod 5 c, the link arm 3 ba of the clamp 3 is rotated oppositedirection, and the movable jaw 3 b is moved into opening direction (abroken line arrow in the figure).

[0120] Accordingly the clamp 3 can be easily opened and closed byoperating the operation part 5 a by one hand.

[0121] Of course an escape for providing the longitudinal penetratingpassage 4 is formed at inside of any of the forceps cylinder 4 a, theslide block 5 e, attachment part of the link pins 5 g of the slide block5 e, and the rear cover 5 h so that the resection blade 7 or the rotaryblade, will be described hereinafter, can be inserted.

[0122]FIG. 4 shows operation of one embodiment of a sealing rod and apush rod provided for the resection blade or the rotatable resectionblade of the present invention. FIG. 4(a) is a vertical section whentissue is cut and FIG. 4(b) is a vertical section after tissue is cut.

[0123] Now detailed construction of the resection blade 7 providedcorresponding to the sealing function of the seal rod 8.

[0124] The resection blade 7 is constructed such that the rear end ofthe hollow and cylindrical main body 7 b provided with the blade 7 a atits tip is inserted in the hollow and cylindrical holding portion 7 c.

[0125] The inner diameter of the main body 7 b isn't uniform. The mainbody 7 b is comprised of a standard inner diameter part 7 ba having thesame inner diameter as the blade 7 a portion and an escape innerdiameter part 7 bb having the inner diameter larger than the standardinner diameter part 7 ba. The standard inner diameter part 7 ba occupiesalmost the inside of the main body 7 b from the tip with the blade 7 ato the rear end and the escape inner diameter part 7 bb occupies only ata fixed distance from the rear end. These two inner diameter parts 7 baand 7 bb are connected by a gently tapered part 7 bc.

[0126] The inner diameter of the holding portion 7 c is tiered andcomprised of an inserting hole 7 ca for tightly inserting the rear endof the main body 7 b and a guide hole 7 cb of which inner diameter issmaller than that of the inserting hole 7 ca and also is the same as ora little larger than the standard inner diameter part 7 ba of the mainbody 7 b. The resection blade 7 is constructed such that the rear end ofthe main body 7 b is inserted in the inserting hole 7 ca of the holdingpart 7 c so as to bump into the tiered portion of the inserting hole 7ca and the guide hole 7 cb.

[0127] According to such a resection blade 7, the resection blade 7 canbe held by the holding part 7 c and also sealing function of the sealingrod 8 can be brought out effectively as mentioned herein.

[0128] The sealing rod 8 is inserted in the guide hole 7 cb of theholding part 7 c from the rear end of the resection blade 7 and isprovided with an rod part 8 b having a little smaller external diameterthan the inner diameter of the standard inner part 7 ba of the main body7 b and a rib 8 a contacting the rear end of the holding part 7 c. Andthe center of the sealing rod 8 is formed with a push hole 8 c forairtightly inserting the push rod 9 along the axial direction.

[0129] An O-ring 8 d is provided at an appropriate portion of theexternal diameter of the rod part 8 b and has an sealing effect for thestandard inner diameter part 7 ba and doesn't have an sealing effect forthe escape inner diameter part 7 bb. Namely the external diameter of theO-ring 8 d is larger than the inner diameter of the standard innerdiameter part 7 ba and smaller than the inner diameter of the escapeinner diameter part 7 bb.

[0130] Therefore, the O-ring 8 d is positioned in the escape innerdiameter part 7 bb of the main body 7 b and sealing function between theO-ring 8 d and the escape inner diameter port 7 bb doesn't achieved inFIG. 4(a). So, air in a hollow part 7 d in the resection blade 7 isallowed to be communicated outside from the sealing rod 8 side via thespace between the standard inner diameter part 7 ba and a head 9 c ofthe push shaft 9, the space between the standard inner diameter 7 ba,the escape inner diameter part 7 bb, the guide hole 7 cb of the holdingportion 7 c and the rod part 8 b of the sealing rod 8. Under such acondition, the resection blade 7 is pressed on the tissue so that thetissue sample Ac is taken in the hollow part 7 d of the resection blade7 (see FIG. 4(b)).

[0131] On the other hand when the sealing rod 8 is fully pushed into theresection blade 7 as shown in FIG. 4(b), the O-ring 8 d is positioned inthe standard inner diameter part 7 ba of the main body 7 b so that airin the hollow part 7 d of the resection blade 7 is sealed not tocommunicate outside from the sealing rod 8 side. When the O-ring 8 dmoves to the standard inner diameter part 7 ba from the escape innerdiameter part 7 bb, it isn't damaged because it moves in the gentlytapered part 7 bc.

[0132] When such a sealing is accomplished, the hollow part 7 d of theresection blade 7 is covered with the tissue sample Ac at its tip sothat the tissue sample Ac doesn't easily dropped off the resection blade7 because negative pressure is applied on the hollow part 7 d when thesample Ac is going to be dropped from the resection blade 7.

[0133] O-rings 8 e, 8 f are provided for the forward and rear parts ofthe push hole 8 c penetrating the center of the rod part 8 b and the rib8 a so that the push rod 9 can move back and forth while keepingairtight between the push hole 8 c and the rod portion 9 b of the pushrod 9 inserted therein.

[0134] The push rod 9 is comprised of the rod portion 9 b and a rib 9 aprovided at its rear end and the head 9 c provided at its forward end.The external diameter of the head 9 c is a little smaller than the innerdiameter of the hollow cylinder of the resection blade 7. The head 9 cis detachable for the rod portion 9 b by an appropriate associationmeans such as a screw and can be disassembled so that the push rod 9 isremoved from the sealing rod 8 in case of sterilization.

[0135] When cutting tissue, the sealing shaft 8 is inserted into theposition where the O-ring 8 d of the sealing rod 8 allows communicationwith outside air and the push rod 9 is set at the position where enoughspace for containing the tissue to be cut is remained at the tip of thehead 9 c.

[0136] In such a case, when the tissue A is grasped by the clamp 3 andis cut by the blade 7 a by forwarding the resection blade 7, air can beleaked from the sealing rod 8 side even if the hollow cylinder of theresection blade 7 is covered with the cut tissue sample Ac and sealedairtightly as explained about FIG. 1. Therefore, cutting operation oftissue can't be hindered. And the rear end of the resection blade 7 isinserted by the sealing rod 8 so that leakage of waste such as bodyfluid and blood in abdominal cavity along the hollow cylinder of theresection blade 7 into outside is reduced.

[0137] After cutting tissue, the sealing rod 8 is pushed in theresection blade 7 at the position where the O-ring 8 d of the sealingrod 8 keeps airtight and the push shaft 9 is remained at it is, as shownin FIG. 4(b).

[0138] Under such a condition, the inside of the resection blade 7 iskept airtight by the tissue sample Ac, the O-ring 8 d of the sealing rod8, and the O-rings 8 e, 8 f of the push rod 9 as mentioned above. Whenthe resection blade 7 is retracted from the forceps 6 while containingthe cut and obtained tissue sample Ac at its tip and is moved to aprepared sample tray with the contained side downward, the containedtissue sample Ac doesn't dropped from the resection blade 7 because ofatmospheric pressure.

[0139] After the resection blade 7 reaches the prepared sample tray, thesealing rod 8 is positioned like FIG. 4(a) and the contained tissuesample Ac is extruded by pushing the push rod 9.

[0140] Accordingly the tissue A can be surely cut and the cut andsampled tissue sample Ac can be collected safely and certainly.

[0141]FIG. 5 shows operation of another embodiment of a sealing rod anda push rod used for a resection blade or a rotating resection blade ofthe present invention. FIG. 5(a) shows a vertical section when tissue iscut and FIG. 5(b) shows a vertical section after tissue is cut.

[0142] A push shaft 11 has both functions of the sealing rod 8 and thepush rod 9 in FIG. 4 and a sealing rod 10 only has an auxiliary functionto seal or allow communication with outside air.

[0143] The shape of the push rod 11 is almost the same as the push rod 9in FIG. 4 and is comprised of a rib 11 a, an rod part 11 b and a head 11c. Differently, an O-ring lid for keeping airtight with the innerdiameter of the hollow cylinder of the resection blade 7 is provided forthe head lic and an air vent hole 11 e penetrating the center of thepush rod 11 is provided.

[0144] The sealing rod 10 is used for sealing the air vent hole lie ofthe push rod 11.

[0145] When cutting tissue (FIG. 5(a)), only the push rod 11 is insertedinto the resection blade 7 and the push rod 11 is set at the positionwhere enough space for containing the cut tissue is obtained at the tipof the head 11 c. The air vent hole 11 e isn't sealed so that tissue canbe preferably cut as mentioned above.

[0146] When the sealing rod 10 is inserted in the air vent hole lie ofthe push rod 11 after cutting tissue (FIG. 5(b)), the air vent hole 11 eis sealed so that the cut and sampled tissue sample Ac doesn't drop fromthe contained portion even if the resection blade 7 is extracted andmoved as explained for FIG. 4(b). When the push shaft 11 is furtherpushed after being moved at a predetermined position, the tissue sampleAc is extruded from the tip of the resection blade 7 by air pressurebetween the tissue sample Ac and the head 11 c of the push rod 11 whichare kept airtight.

[0147] In such a case the tissue A can be surely cut and the cut andsampled tissue sample Ac can be collected safely and certainly.

[0148] If the construction members of the above-mentioned clamp 3comprised of the chopping block piece 2, the fixed jaw 3 a, and themovable jaw 3 b, the forceps cylinder 4 a having the penetrating passage4, the open-close mechanism 5, the operation part 5 a and the resectionblade 7 are made of material excellent for sterilization and chemicalproof, they are appropriate for surgical instruments because they can beeasily sterilized such as autoclave sterilization after used. Forexample, the clamp 3, the forceps cylinder 4 a, members of theopen-close mechanism 5, and the resection blade 7 are preferably made ofstainless steel and the O-ring for sealing is made of silicon rubber.

[0149] Next, one embodiment of actual procedures for sampling tissuesample using a tissue excision and cutting apparatus of the presentinvention in case of laparoscopic surgery will be explained.

[0150]FIG. 6 to FIG. 10 explain the procedure at five stages.

[0151] At the step 1 (FIG. 6), an inserting instrument F for insertingan endo-bag E in abdominal cavity H and a trocar T are set at a trocarsite J of patient's abdomen I. In the figure, the endo-bag E is alreadyinserted in the abdominal cavity H by the inserting instrument F, isexpanded and contains the extracted organ A, an opening of the endo bagE is taken out of the trocar site F, the trocar T is inserted into thetrocar site J, sterilized distilled water is injected into a trocar cuffTA provided for the trocar T so as to be expanded, and sealing betweenthe trocar site J and the trocar T is kept.

[0152] On the other hand, the auxiliary opening for the endo-bag E isset at the inserting instrument F and a laparoscope G is inserted in theauxiliary opening so as to observe inside of the endo-bag E.

[0153] At first the forceps 6 is inserted into the trocar T and theorgan A is grasped by operating the operation part 5 a of the forceps 6while confirming the position of the organ A by the laparoscope G.

[0154] At the step 2 (FIG. 7), the resection blade 7 is inserted intothe longitudinal penetrating passage 4 of the forceps 6. In this time,the forceps 6 is held by one hand while grasping the organ A and theresection blade 7 can be easily inserted by holding the holding portion7 c by another hand. The sealing rod 8 with the push rod 9 is preparedfor the resection blade 7 in such a manner that the resection blade 7 isallowed to be communicated with the air from the sealing rod 8 as shownin FIG. 4(a).

[0155] At the step 3 (FIG. 8), the tissue which is grasped by the clamp3 and received by the chopping block piece 2 is finely and surely cutwhile the resection blade 7 is rotated right or left by a hand ifnecessary. The cut end is pressed and cut by the blade 7 a of theresection blade 7 and the chopping block piece 2 or is sheared and cutby the blade 7 a and a receiving blade (not shown) provided at thechopping block piece 2 depending on the shape of the blade 7 a. Theresection blade 7 is guarded with the clamp 3 so that tissue can besafely cut without damaging the endo-bag E by the blade 7 a of theresection blade 7 is extruded.

[0156] At the step 4 (FIG. 9), the sealing rod 8 is fully inserted inthe resection blade 7 and the resection blade 7 is extracted from theforceps 6 while sealing the hollow cylinder containing the cut tissuesample Ac.

[0157] At the step 5 (FIG. 10), the extracted resection blade 7 is movedto a sample tray K, the position of the sealing rod 8 is returned towhere communication with outside air is allowed, then the tissue sampleAc contained at the tip in the hollow cylinder of the resection blade 7.

[0158] Accordingly, the tissue can be surely cut and the sampled tissuesample can be certainly moved to a prepared position.

[0159] Such an organ for cutting and sampling tissue thereof isgenerally attacked by malignant in many cases so that it is highlyrequired to prevent that a part of the organ is leaked out of theendo-bag E, the endo-bag E itself is damaged, or the other normal organis damaged or broken. According to the present invention, the blade 7 ais constructed so as not to go forward the chopping block piece 2 sothat such a danger isn't caused.

[0160] When the forceps of the present invention is used together with arotatable resection blade which rotates automatically, its effect isfurther brought out.

[0161]FIG. 11 is a partial cutaway front view showing one embodiment ofthe forceps of the present invention combined with the rotatableresection blade.

[0162] A tissue excision and cutting apparatus 1A is different from theapparatus 1 in that a resection blade is a rotatable resection blade 12.The rotatable resection blade 12 includes a guide cylinder 13 acontaining the rotatable resection blade 12 rotatably, a warm mechanism13 b with a warm and a warm wheel for driving and rotating the resectionblade 12, and a driving and rotating mechanism 13 containing a mechanismfor transmitting rotating power to the warm mechanism 13 b and comprisedof a transmission part 13 c which can be a holding part of the resectionblade 12 and a motor 13 d as a drive source.

[0163] The driving and rotating mechanism 13 is provided with acontroller such as a foot controller (not shown) for controlling on oroff of driving and its rotation number so that rotation of the rotatableresection blade 12 can be controlled freely while operating the forceps6 by one hand and grasping a transmission part 13 c of the blade 12 byanother hand.

[0164] Therefore, according to the tissue excision and cutting apparatus1A, the tissue A which is grasped by the clamp 3 and received by thechopping block piece 2 like a cutting board can be finely cut.

[0165] The warm mechanism 13 b is shown as one sample of thetransmission mechanism for transmitting the rotational movement intoperpendicular direction and the present invention isn't limited by sucha warm mechanism 13 b. For example, a mechanism combined with a bevelwheel may be used if the rotational movement is transmittedperpendicular. The driving and rotating mechanism 13 isn't limited tothe above-mentioned one if the hollow cylindrical part is assured in theresection blade. For example, a direct drive electric motor comprisingthe rotary blade itself as a rotor thereof may be used and in such acase the above-mentioned warm mechanism isn't required.

[0166] The resection blade which is used together with the forcepscomprising the tissue excision and cutting apparatus of the presentinvention may be rotated or not rotated. Further any resection blade canbe combined if the cutting board function of the chopping block piece ofthe resection blade can be effectively utilized. Therefore, the forcepsalone is available for a resection forceps 6A (FIG. 1) and in such acase it can execute cutting operation more finely and surely cooperatingwith the combined resection blade.

[0167] The chopping block piece and the sealing mechanism of theforceps, a drop-out prevention means and a suction means provided forthe resection blade as an active means for preventing drop out of thetissue sample after sampled, which are other characteristics of thetissue excision and cutting apparatus of the present invention, will beexplained hereinafter.

[0168]FIG. 12 shows another embodiment of the forceps of the tissueexcision and cutting apparatus of the present invention. FIG. 12(a) is afront view of a partial vertical section and FIG. 12(b) is a fragmentalview in the direction of the arrow X.

[0169] At first FIG. 12(b) is explained. In this figure, the resectionblade which is contacted with the chopping block piece 2 or the blade 7a of the rotatable resection blade is virtually shown by dotted lines.

[0170] The forceps 6 is constructed such that the size of the choppingblock piece 2 provided at the tip of the fixed jaw 3 is designed to becontacted with the whole circumference of the blade 7 a of the resectionblade or the rotatable resection blade which is inserted in thelongitudinal penetrating passage 4 of the forceps 6, as shown in thefigure. Therefore, the chopping block piece 2 can be effected as acutting board for any parts of the blade 7 a and cutting end of tissuecan be completely done so that the tissue sample can be completely cutand separated.

[0171] It isn't required to rip down the cut end by pulling the cuttissue sample with the forceps which has been done in the prior art.Therefore, tissue sample can be cut and sampled finely.

[0172] The virtual lines of the blade 7 a almost correspond to the shapeof the longitudinal penetrating passage 4 and the above-mentioned effectcan be expected for the resection blade or the rotatable resection bladewhich can be inserted in the penetration passage 4.

[0173] Then the front view of the FIG. 12(a) will be explained. As shownin the figure, the forceps 6 is detachably provided with a sealingmechanism 5 i at the end of the open-close mechanism 5.

[0174]FIG. 13 is a partial vertical section explaining its sealingmechanism and FIG. 13(a) shows when the sealing mechanism is loaded,FIG. 13(b) shows after it is loaded, and FIG. 13(c) shows when theresection blade or the rotatable resection blade is inserted.

[0175] The sealing mechanism 5 i is comprised of a sealing body 5 ia, asealing ring 5 ib, a presser board 5 ic, a sealing plate 5 id, a spring5 ie, a setscrew 5 if, an auxiliary ring 5 ig, and an O-ring 5 ih.

[0176] The sealing body 5 ia is approximately cylindrical as shown inthe figure and one end of the external diameter is detachably insertedinto an insertion hole provided at the rear end of the open-closemechanism 5. A penetrating hole is provided in the inner diameter forsecuring the longitudinal penetrating passage 4 in sequence of theopen-close mechanism 5.

[0177] The sealing ring 5 ib is provided opposite to the inserted sideof the open-close mechanism 5 with the sealing body 5 ia and is fixedwith the presser board 5 ic. The sealing body 5 ia is like a circulardisc with a hole made of rubber and the diameter of the hole is a littlesmaller than that of the longitudinal penetrating passage 4. When theresection blade is inserted in the hole, the hole is designed to sealits external diameter.

[0178] The seal plate 5 id is enforced by the spring 5 ie so as to openand close the hole provided at the intermediate part of the seal body 5ia in axial direction. The setscrew 5 if is provided at the rear end ofthe open-close mechanism 5 for fixing and holding the detachablyinserted seal body 5 ia.

[0179] The auxiliary ring 5 ig is provided at the position which is therear end of the forceps inner cylinder 4 b comprising a double cylinderin the forceps cylinder 4 a and also the seal body 5 ia is contacted andit is formed with a groove for containing the O-ring 5 ih. The O-ring 5ih is designed to keep sealing between the seal body 5 ia and theforceps inner cylinder 4 b when the seal body 5 ia is inserted in therear end of the open-close mechanism 5. The inner diameter part of theforceps inner cylinder 4 b is formed the longitudinal penetratingpassage 4.

[0180] The sealing mechanism 5 i is constructed such that the seal body5 ia having the seal ring 5 ib and the sealing plate 5 id is detachablyinserted into the rear end of the open-close mechanism 5 as shown inFIG. 13(a) and the mechanism 5 i is fixed by the setscrew 5 if as shownin FIG. 13(b), thereby exerting its function.

[0181] As shown in FIG. 13(b), when the resection blade or the rotatableresection blade isn't inserted in the longitudinal penetrating passage4, the seal plate 5 id of the sealing mechanism 5 i is enforce by thespring 5 ie so that the hole of the seal body 5 ia is closed and thelongitudinal penetrating passage 4 and outer air are sealed. Althoughthe seal plate 5 id is enforced by the spring 5 ie, its enforcing poweris set so as to fell down the seal plate 5 id when pushed by theinserted resection blade.

[0182] As shown in FIG. 13(c), when the resection blade or the rotatableresection blade is inserted in the longitudinal penetrating passage 4,the seal plate 5 id is pushed and fell down by the resection blade so asnot to prevent the resection blade from inserting. The periphery of theblade 7 b of the inserted resection blade or the guide cylinder 13 a ofthe rotatable resection blade is sealed from outside by affected by theinner diameter of the sealing ring 5 ib.

[0183] Accordingly, the longitudinal penetrating passage 4 is keptsealed whenever the resection blade is inserted or not so that outer airis prevented from entering in abdominal cavity and the endo-bag throughthe longitudinal penetrating passage 4 or especially pneumoperitoneumgas is prevented from leaking out while being filled in the endo-bag.

[0184] Because the seal body 5 ia is exchangeable, it can be exchangedwhen polluted, thereby keeping safety without executing troublesomesterilization.

[0185] The above-mentioned forceps is explained as a member of thetissue excision and cutting apparatus, however it doesn't matter thekind of the resection blade or the rotatable resection blade which isused together with the forceps. The forceps, as mentioned above, hasindependent utility value and technical value. Therefore, it can be usedas a resection forceps 6A (FIG. 12, FIG. 13) alone and has similareffect cooperating with the combined resection blade.

[0186] Next the drop-out prevention means and the suction means providedfor the resection blade as an active means for preventing the sampledtissue sample will be explained.

[0187]FIG. 14 shows one embodiment of a holding craw provided at theinternal tip of the resection blade or the rotatable resection blade.FIG. 14(a) is its front view and Fib. 14(b) is a partial verticalsection.

[0188] A holding craw 7 e provided at an inner circumference of theblade 7 a of the resection blade 7 is the same one which is used forpreventing dropping out of fish after hooked by a fishhook and is one ofdrop-out prevention methods of the sampled tissue sample.

[0189] In this embodiment, the blade 7 a is made of stainless steelcapable of hardening, for example SUS440C, for keeping sharpness of theblade. It is different from the material used for the resection bladebody 7 b such as titanium or stainless steel of SUS304. Therefore, theblade 7 a is integrated with the body 7 b by a tight insertion of aninsertion integration part 7 g after appropriate procedures such assharpening and hardening of the blade 7 a are executed.

[0190] The holding craw 7 e is formed such that a radius shape is formedby turnery and substantial part is ground from the entire circumferenceof the radius shape formed around the circumference so as to leave threeholding craws 7 e as shown in the figures.

[0191] If the holding craw is formed circumferential, it is excellentfor drop-out prevention, however, contrarily the cut tissue sample whichhas been cut into cylindrical by the tip blade and fed in the inmostrecesses of the resection blade 7 in turn is prevented from being fedinto further inmost recess.

[0192] Therefore, the holding craw 7 e is partially left and threeholding craws are appropriate as shown in the figure, however from twoto five holding craws may be provided.

[0193] According to such about three holding craws 7 e doesn't hinderthe tissue sample from being fed and can prevent the tissue sample fromdropping out.

[0194] The holding craws are appropriately positioned not far from thetip of the blade 7 a in the blade axis direction, more concretely, wherethe shortest one of the usually formed cylindrical tissue samples can behooked. Further, the holding craws may be provided in a line as shown inthe figure, however they may be provided in plural lines at differentpositions from the tip in the direction of the blade axis by differingcircumferential position or at the same circumferential position.

[0195] Such a holding craw may be similarly provided for the rotatableresection blade 12 (FIG. 11) and such a case is shown as the parentheticnumerals in the figures such as a rotatable resection blade 12, a blade12 a, a body 12 b, a holding craw 12 e.

[0196]FIG. 15 is an external front view of one embodiment of a rotatableresection blade provided with holding craw 12 e as shown in FIG. 14.

[0197] The holding craw 12 e can be similarly provided for a rotatableresection blade and have the same effect.

[0198]FIG. 16 shows another embodiment of a holding craw provided insidetip of a resection blade or a rotatable resection blade of the presentinvention. FIG. 16(a) is its front view and FIG. 16(b) is its partialvertical section.

[0199] The holding craw 7 f is provided for the body 7 b of theresection blade 7 comparing to the holding craw 7 e of FIG. 14 and isformed by plastic forming of the blade body 7 b made of lightweighttitanium, and excellent for anti-corrosion, and plasticity or SUS304stainless steel which is excellent for anti-corrosion and easy to bemanufactured.

[0200] The holding craw 7 f is designed t prevent the cut tissue samplefrom dropping out like the holding craw 7 e of FIG. 14. However, theholding craw 7 f is shaped by plastic forming with shearing and pressingagainst the relatively thin cylindrical part of the blade body 7 b.

[0201] Its drop-out prevention effect isn't different from the holdingcraw 7 e, however, it must be provided for the body 7 b because of themanufacturing performance so that it must be provided at substantialdistance from the tip of the blade 7 a. In this point the holding craw 7f isn't suitable for preventing dropping out of a short tissue sample.

[0202] Both of the holding craw 7 e and 7 f may be provided.

[0203] The holding craw 7 f can be provided for the rotatable resectionblade 12 like the holding craw 7 e and such a case is shown asparenthetic numbers in the figure.

[0204]FIG. 17 is a partial vertical section explaining operation of oneembodiment of a sealing rod used for a resection blade or a rotatableresection blade of the present invention.

[0205] The sealing push rod 8A is constructed like the push rod 11 inFIG. 5 and they are different in that the sealing push rod 8A isprovided with a simple suction means 8 g actively generating suctionforce in place of the sealing rod 10, the simple suction means 8 g isone embodiment of a suction means of the cut and sampled tissue sample.

[0206] The sealing push rod 8A itself is constructed with a rib 8Aa, anrod part 8Ab, a head 8Ac, an O-ring 8Ad, and an air vent hole 8Ae likethe push rod 11 in FIG. 5 and they work like those for the push rod 11.

[0207] The simple suction means 8 g detachably provided for the air venthole 8Ae instead of the sealing rod 10 is comprised of a syringe 8 ga, aswitch valve 8 gb, and a tube 8 gc.

[0208] The simple suction means 8 g isn't loaded before the sealing rod8A is inserted in the resection blade 7 and it cuts and samples tissueso as not to disturb cutting and sampling of tissue by allowingcommunication of air from the air vent hole 8Ae.

[0209] However, as shown in FIG. 17, the simple suction means 8 g isloaded after the tissue sample Ac is sampled, the switch valve 8 gb isopened, and suction force is generated by operating the syringe 8 ga soas to actively suck the sampled tissue sample Ac not to be dropped out.

[0210] After the resection blade 7 is moved at a predetermined positionwhile keeping suction, the contained tissue sample Ac may be extruded bygenerating pressure force by operating the syringe 8 ga of the simplesuch means 8 g, or it may be extruded only by the operation of thesealing push rod 8A after removing the simple suction means 8 g.

[0211] The switch valve 8 gb may be closed after sucking with thesyringe 8 ga to keep suction force. When it can be replaced by theoperation of the syringe 8 ga, the switch valve 8 gb isn't alwaysrequired.

[0212] In this case a syringe is used as a sample of the simple suctionmeans 8 g because it is easily obtained at medical sites, however itisn't limited.

[0213]FIG. 18 explains operation of another embodiment of a sealing rodand a push rod used for a resection blade or a rotatable resection bladeof the present invention. FIG. 18(a) is a partial vertical sectionbefore tissue is cut, FIG. 18(b) is a partial vertical section aftertissue is cut, and FIG. 18(c) is a partial vertical section when atissue sample is suck and held.

[0214] A sealing suction rod 8B and a push rod 9A are the same as thesealing rod 8 and the push rod 9 in FIG. 4. However, a sealing suctionmechanism 8 h is provided for the sealing suction rod 8B. The push rod9A and a resection blade 7A are a little different from those in FIG. 4.The sealing suction rod 8B and the push rod 9A are another embodiment ofthe suction means of cut and sampled tissue sample.

[0215] The resection blade 7A is different from the resection blade 7 inFIG. 4 in that a container 7Ae containing the sealing suction mechanism8 h is included in a holding portion 7Ac corresponding to the sealingsuction rod 8B provided with the sealing suction mechanism 8 h. It alsodifferent in that a part connected from the container 7Ae to the hollow7Ad in the resection blade 7A is a sealing tapered part 7Af. A blade7Aa, a body 7Ab, the holding portion 7Ac and the hollow 7Ad are the sameas those of the resection blade 7.

[0216] A rib 8Ba, an rod part 8Bb, and a push hole 8Bc of the sealingsuction rod 8B are almost the same as those of the sealing rod 8. It isdifferent in that a piston flange 8 he to be contained in the sealingsuction mechanism 8 h is provided at the tip of the rod part 8Bb.

[0217] The sealing suction mechanism 8 h is comprised of a sealingcylinder 8 ha slidably contained in the container 7Ae of the resectionblade 7A, an inner chamber 8 hb provided therein, a communicationpassage 8 hc for communicating air between the inner chamber 8 hb andthe hollow 7Ad of the resection blade 7A, an O-ring 8 hd which isprovided at the tip of the hollow 7Ad side of the sealing cylinder 8 haand exerts sealing function when it contacts with the sealing taperedpart 7Af of the resection blade 7A, the above-mentioned piston flange 8he sliding airtightly in the inner chamber 8 hb, a spring 8 hf enforcingthe piston flange 8 he in the left direction in FIG. 18, and a spring 8hg provided at the tip of the hollow 7Ad of the sealing cylinder 8 haand enforcing the sealing cylinder 8 ha in the left direction of FIG. 18by generating enforce power between an inner wall of the container 7Adof the resection blade 7A.

[0218] The spring 8 hf is designed to require larger force than thespring 8 hg to be compressed the same length so that the spring constant(load/distortion) of the spring 8 hf becomes larger than the spring 8hg.

[0219] The push rod 9A is comprised of a rib 9Aa, an rod part 9Ab, and ahead 9Ac like those of the push rod 9 in FIG. 4. The push hole 8Bc ofthe sealing suction rod 8B, the spring 8 hf and the sealing cylinder 8ha of the sealing suction mechanism 8 h are penetrated by the rod part9Ab and the push hole 8Bc and the sealing cylinder 8 ha are sealed by anappropriate sealing means such as an O-ring so as to be slidable keepingairtight.

[0220] The holding portion 7Ac of the resection blade 7A is constructedsuch that the container 7Ae can be opened, the sealing cylinder 8 ha ofthe sealing suction mechanism 8 h is constructed so as to be able toopen the inner chamber 8 hb, and the head 9Ac of the push rod 9A isconstructed detachable. As shown in the figure they can be disassembledafter assembled and used.

[0221] When tissue sample is cut and sampled by means of the sealingsuction rod 8B and the push shaft 9A, the sealing suction rod 8B ispositioned freely as shown in FIG. 18(a). The distance between the rib8Ba of the sealing suction rod 8B and the holding portion 7Ac of theresection blade 7A is defined as L1. The push rod 9A is positioned so asto keep enough space for containing the cut tissue sample in the hollow7Ad forward of the head 9Ac. The hollow 7Ad in the resection blade 7A iscommunicated with air because of the space between the sealing suctionrod 8B, and sealing cylinder 8 ha and the container 7Ae of the holdingportion 7Ac.

[0222] After tissue sample is cut by the tissue excision and cuttingapparatus 1 having the resection blade 7A, only the sealing suction rod8B is pushed as shown in FIG. 8(b). Because the spring 8 hg is strongerthan the spring 8 hf, the sealing cylinder 8 ha slides forward in thecontainer 7Ae of the holding portion 7Ac by the just distance that thesealing suction rod 8B is pushed. The O-ring 8 hd provided at the tip ofthe sealing cylinder 8 ha contacts with the sealing tapered part 7Af ofthe holding portion 7Ac and the hollow 7Ad in the resection blade 7A iskept airtight by the sealing cylinder 8 ha. The distance between the rib8Ba of the sealing suction rod 8B and the holding portion 7Ac of theresection blade 7A is defined as L2.

[0223] When only the sealing suction rod 8B is further pushed, thesealing cylinder 8 ha doesn't further slide and only the sealing suctionrod 8B slides forward against the sealing cylinder 8 ha whilecompressing the spring 8 hf as shown in FIG. 18(c). The piston flange 8he of the sealing suction rod 8B slides forward while keeping airtightin the inner chamber 8 hb of the sealing cylinder 8 ha so that suctionforce is generated in the space in the rear of the piston flange 8 heand is transmitted to the hollow 7Ad of the resection blade 7A via thecommunication passage 8 hc. Accordingly suction force is generated inthe hollow 7Ad. The distance between the rib 8Ba of the sealing suctionrod 8B and the holding portion 7Ac of the resection blade 7A is definedas L3.

[0224] Sealing and suction can be achieved and the cut and sampledtissue sample Ac can be easily suck and grasped simply by pushing thesealing suction rod 8B from a free condition L1 to the distances L2 andL3. After the resection blade 7A holding the tissue sample Ac is movedat a predetermined place, the sealing suction rod 8B can be returned toits original free position L1 by the force of repulsion of the springs 8hf, 8 hg only by releasing pushing of the sealing suction rod 8B. Thenthe tissue sample Ac can be easily extruded by operating the push rod9A.

[0225] It is more convenient that a lock means which can keep thesealing suction rod 8B at the distance L3 and can be easily released isprovided if required.

[0226]FIG. 19(a)-FIG. 19(f) explain operation of a suction and samplingmeans used for a resection blade or a rotatable resection blade of thepresent invention.

[0227] This suction and sampling means 14 is provided for activelycollecting the tissue sample cut and sampled by the resection blade in asample container not only by sucking and grasping but also by utilizingair suction force. It is another embodiment of a suction means of tissuesample.

[0228] The suction and sampling means 14 is comprised of a samplecontainer 14 a which is a bag made of mesh material for passing suctionforce and provided with an attachment opening, a connecting means 14 bfor connecting the sample container 14 a and a connecting part 7Ba atthe rear of a resection blade 7B, and a cover 14 c provided for theconnecting means 14 b and covering the sample container 14 a fully forkeeping airtight.

[0229] The resection blade 7B connected with the suction and samplingmeans 14 is different from the above-mentioned resection blade 7, 7B inthat it is provided with the connecting part 7Ba at its rear end. Aconnecting groove 7Bb is provided for the connecting part 7Ba for fixingthe connecting means 14 b of the suction and sampling means 14 and aconnecting pin 14 ba is vertically provided for the connecting means 14b to be inserted in the groove 7Bb.

[0230] When the suction and sampling means 14 is used, at first theconnecting means 14 b is set for the sample holder 14 a (FIGS. 19(a),(b)), then the cover 14 c is covered (FIG. 19(c)), and the assembledsuction and sampling means 14 is connected and fixed to the connectingpart 7Ba of the resection blade 7B by utilizing association of theconnecting pin 14 ba and the connecting groove 7Bb (FIG. 19(d)).

[0231] Then suction force is supplied to the suction and sampling means14 from an suction air source (not shown) and the tissue sample cut andsampled by the resection blade 7B is suck and collected (FIG. 19(e)).This suction and collection may be repeated until a purpose isaccomplished more than one time.

[0232] After suck and collection are finished, the suction and samplingmeans 14 is removed from the resection blade 7B and disassembled. Thetissue sample collected in the sample container 14 a is taken out at apredetermined place (FIG. 19(f)).

[0233] Accordingly tissue samples taken out several times can be easilycollected and taken out in bulk.

[0234] This suction and sampling means can be used for a rotatableresection blade. Both of the above-mentioned holding craw and severalsuction means for preventing dropping out of tissue sample can beapplied for a resection blade or a rotatable resection blade. In such acase both effects can be synergistically brought out.

[0235] While the present invention has been particularly shown anddescribed with reference to preferred embodiments thereof, it will beunderstood by those skilled in the art that the foregoing and otherchanges in form and details can be made therein without departing fromthe spirit and scope of the invention.

1. A tissue excision and cutting apparatus used by inserted into a trocar for cutting off a part of tissue for sampling in a laparoscopic surgery or the like comprising: a resection blade having an inner hollow cylinder body formed with a cutting blade at its tip end, and a forceps for cutting off a part of tissue as a sample piece, said forceps having a clamp for grasping a part of tissue to be cut off, said clamp having a movable jaw capable of opening and closing which is joined to a fixed jaw with a chopping block piece, an open-close mechanism with an operation part for opening and closing said movable jaw, and a longitudinal penetrating passage into which said resection blade is inserted and moves back and forth therein.
 2. A tissue excision and cutting apparatus used by inserted into a trocar for cutting off a part of tissue for sampling in a laparoscopic surgery or the like comprising: a resection blade having an inner hollow cylinder body formed with a cutting blade at its tip end, said resection blade being driven by a rotary driving mechanism, and a forceps for cutting off a part of tissue as a sample piece, said forceps having a clamp for grasping a part of tissue to be cut off, said clamp having a movable jaw capable of opening and closing which is joined to a fixed jaw with a chopping block piece, an open-close mechanism with an operation part for opening and closing said movable jaw, and a longitudinal penetrating passage into which said resection blade is inserted and moves back and forth therein.
 3. The tissue excision and cutting apparatus as set forth in claim 1 or 2 , wherein said operation part of said the open-close mechanism is constructed such that it can be held by one hand and said movable jaw can be opened and closed by manual operation of said one hand.
 4. The tissue excision and cutting apparatus as set forth in claim 1 or 2 , wherein said chopping block piece is formed with a blade receiving surface so as to contact with the whole circumference of said blade of resection blade.
 5. The tissue excision and cutting apparatus as set forth in claim 1 or 2 , wherein said passage is at the rear end provided with an insertion opening for said resection blade and wherein said insertion opening is further provided with a sealing valve mechanism for isolating ventilation into the open air even when said resection blade is put in and out.
 6. The tissue excision and cutting apparatus as set forth in claim 5 , wherein said sealing valve mechanism is detachable and exchangeable for said insertion opening.
 7. The tissue excision and cutting apparatus as set forth in claim 1 or 2 , wherein said resection blade further comprises a sealing rod for airtightly sealing the inner of said hollow cylinder body of said resection blade and a push shaft for outwardly extruding a part of tissue which is cut off by said blade and held in said hollow cylinder body as a sample piece, by being airtightly inserted into said cylinder body from a push hole provided at the rear end of said sealing rod.
 8. The tissue excision and cutting apparatus as set forth in claim 1 or 2 , wherein said resection blade further comprises a sealing push rod which is airtightly inserted into said hollow cylinder body from an insertion opening provided at the rear end of said cylinder body, and a simple suction means connected to said sealing push rod for keeping said inner portion of said hollow cylinder body airtight condition to hold the cut off tissue as a sample piece by said resection blade in said cylinder body.
 9. The tissue excision and cutting apparatus as set forth in claim 1 or 2 , wherein said resection blade further comprises a sealing suction rod into which a sealing suction mechanism is incorporated, said sealing suction rod airtightly sealing the inner portion of said resection blade and keeping airtight condition in the inner portion of said cylinder body to hold the cut off tissue as a sample piece by said resection blade, and a push rod for outward extruding a part of tissue cut off by said resection blade and held in said hollow cylinder body as a sample piece, by being airtightly inserted into said hollow cylinder body from a push hole provided at the rear end of said sealing suction rod.
 10. The tissue excision and cutting apparatus as set forth in claim 1 or 2 , wherein said resection blade further comprises a suction sampling collecting means detachably connected to the rear end of said hollow cylinder for sucking to collect the cut off tissue as a sample piece by said resection blade.
 11. The tissue excision and cutting apparatus as set forth in claim 1 or 2 , wherein said resection blade is in an inner surface adjacent to its tip end provided with a holding craw for preventing dropping out of the cut off tissue as a sample piece by said resection blade.
 12. A forceps used together with a resection blade which is inserted into a trocar for cutting off a part of tissue for sampling in a laparoscopic surgery or the like comprising: a clamp provided at a tip end having a movable jaw capable of opening and closing which is jointed to a fixed jaw with a chopping block piece, an open-close mechanism with an operation part for opening and closing said movable jaw, and a longitudinal penetrating passage into which said resection blade is inserted and moves back and forth therein.
 13. The forceps as set forth in claim 12 , wherein said operation part of said open-close mechanism is constructed such that it can be held by one hand and said movable jaw can be opened and closed by manual operation of said one hand.
 14. The forceps as set forth in claim 12 , wherein said chopping block piece is formed with a blade receiving surface so as to contact with the whole circumference of said blade of resection blade.
 15. The forceps as set forth in claim 12 , wherein said passage is at rear end provided with an insertion opening for said resection blade and wherein said insertion opening is further provided with a sealing valve mechanism for isolating ventilation of the open air even when said resection blade is put in and out.
 16. The forceps as set forth in claim 5 , wherein said sealing valve mechanism is detachable and exchangeable for said opening. 